Background: Continuity of care is a distinguishing feature of primary care. Better continuity of care program showed a significant effect in controlling diabetes and it is complications. This study explores the effect of continuity of care on control of diabetes mellites in primary health care centres. Objectives: 1) To assess the effect of Continuity of care on controlling haemoglobin (Hb A1C) and fasting blood Sugar (FBS); 2) To compare the control of Diabetes by using (Hb A1C and FBS) indices on same patient before and after application of chronic illness clinic; 3) To identify the relation between age and gender affecting continuity of care in diabetic patient. Methods: It is a Prospective cohort study design. Included both gender and diabetic patient age above 24 years old. The data extracted from health care specialty center (HCSC) clinics in National guard hospital at Riyadh, through HCSC data base on three phases: 1) Phase 1: the data extracted of diabetic patients from October to November 2022 including MRN, diabetic patient, age, Hb A1C, Fasting blood glucose. 2) Phase 2: the same MRN extracted from phase 1 was extracted again retrospectively for six months from April to September 2022, to compare the indices before implanting the chronic illness clinic including Hb A1C, Fasting blood glucose. 3) Phase 3: prospectively from December 2022 to September 2023. Results: Among diabetic patients aged 60 years old and above showed better control of HbA1C and FBS comparing to these patients below age of 60 years old, with significant improvement of HbA1C after implanting chronic illness clinic. Conclusion: The significant improvement in the control of diabetic patients followed in primary health care centers reinforce the evidence of the importance of continuity of care.
References
[1]
Starfield, B. (2010) Commentary on Regular Primary Care Lowers Hospitalisation Risk and Mortality in Seniors with Chronic Respiratory Disease. JournalofGeneralInternalMedicine, 25, 758-759. https://doi.org/10.1007/s11606-010-1393-y
[2]
Bazemore, A., Petterson, S., Peterson, L.E., Bruno, R., Chung, Y. and Phillips, R.L. (2018) Higher Primary Care Physician Continuity Is Associated with Lower Costs and Hospitalizations. TheAnnalsofFamilyMedicine, 16, 492-497. https://doi.org/10.1370/afm.2308
[3]
Saultz, J.W. (2003) Defining and Measuring Interpersonal Continuity of Care. TheAnnalsofFamilyMedicine, 1, 134-143. https://doi.org/10.1370/afm.23
[4]
Liang, D., Zhu, W., Qian, Y., Zhang, D., Petersen, J.D., Zhang, W., et al. (2022) Continuity of Care and Healthcare Costs among Patients with Chronic Disease: Evidence from Primary Care Settings in China. InternationalJournalofIntegratedCare, 22, Article 4. https://doi.org/10.5334/ijic.5994
[5]
Harris, M.F. and Zwar, N.A. (2007) Care of Patients with Chronic Disease: The Challenge for General Practice. MedicalJournalofAustralia, 187, 104-107. https://doi.org/10.5694/j.1326-5377.2007.tb01152.x
[6]
Jarrar, M., Abusalah, M.A.H., Albaker, W., Al-Bsheish, M., Alsyouf, A., Al-Mugheed, K., etal. (2023) Prevalence of Type 2 Diabetes Mellitus in the General Population of Saudi Arabia, 2000-2020: A Systematic Review and Meta-Analysis of Observational Studies. SaudiJournalofMedicine&MedicalSciences, 11, 1-10. https://doi.org/10.4103/sjmms.sjmms_394_22
[7]
Parchman, M.L., Pugh, J.A., Noël, P.H. and Larme, A.C. (2002) Continuity of Care, Self-Management Behaviors, and Glucose Control in Patients with Type 2 Diabetes. MedicalCare, 40, 137-144. https://doi.org/10.1097/00005650-200202000-00008
Imai, C., Li, L., Hardie, R. and Georgiou, A. (2021) Adherence to Guideline-Recommended HbA1c Testing Frequency and Better Outcomes in Patients with Type 2 Diabetes: A 5-Year Retrospective Cohort Study in Australian General Practice. BMJQuality&Safety, 30, 706-714. https://doi.org/10.1136/bmjqs-2020-012026
[10]
Chan, K., Wan, E.Y., Chin, W., Cheng, W.H., Ho, M.K., Yu, E.Y., etal. (2021) Effects of Continuity of Care on Health Outcomes among Patients with Diabetes Mellitus and/or Hypertension: A Systematic Review. BMCFamilyPractice, 22, Article No. 145. https://doi.org/10.1186/s12875-021-01493-x
[11]
Hussein, G., Al Saud, A.A., Siddiqi, A.M., Khasawinah, A., Alenezi, A., Mohammed, R.A., etal. (2023) The Impact of Continuity of Care on Health Indicators in Patients with Type 2 Diabetes Mellitus in Family Medicine Clinics in Riyadh. Cureus, 15, e43410. https://doi.org/10.7759/cureus.43410